RESUMEN

Dynamic models of the protoplanetary disk indicate there should be large-scale material transport in and out of the inner Solar System, but direct evidence for such transport is scarce. Here we show that the ε50Ti-ε54Cr-Δ17O systematics of large individual chondrules, which typically formed 2 to 3 My after the formation of the first solids in the Solar System, indicate certain meteorites (CV and CK chondrites) that formed in the outer Solar System accreted an assortment of both inner and outer Solar System materials, as well as material previously unidentified through the analysis of bulk meteorites. Mixing with primordial refractory components reveals a "missing reservoir" that bridges the gap between inner and outer Solar System materials. We also observe chondrules with positive ε50Ti and ε54Cr plot with a constant offset below the primitive chondrule mineral line (PCM), indicating that they are on the slope ∼1.0 in the oxygen three-isotope diagram. In contrast, chondrules with negative ε50Ti and ε54Cr increasingly deviate above from PCM line with increasing δ18O, suggesting that they are on a mixing trend with an ordinary chondrite-like isotope reservoir. Furthermore, the Δ17O-Mg# systematics of these chondrules indicate they formed in environments characterized by distinct abundances of dust and H2O ice. We posit that large-scale outward transport of nominally inner Solar System materials most likely occurred along the midplane associated with a viscously evolving disk and that CV and CK chondrules formed in local regions of enhanced gas pressure and dust density created by the formation of Jupiter.

RESUMEN

The geographic distribution of the stable isotope ratio of Sr (87Sr/86Sr) is useful for identifying the provenance of drinking water, organisms, and agricultural products. To explore how environmental factors influence this ratio, we determined the 87Sr/86Sr, sulfur isotope ratio (δ34S), and elemental composition of 208 commercially available bottled waters in Japan, and compared them with the 87Sr/86Sr values of groundwater, rainwater, rocks, and vegetables from similar localities. We classified the bottled waters into seven categories based on the geology of their source aquifers. The 87Sr/86Sr and concentrations of several elements (Ca, K, Si, Rb, and Ba) of the bottled waters differed with the aquifer rock type and were well correlated with the 87Sr/86Sr of reported spring waters, indicating that bottled water, like other groundwater, reflects the lithology and chemistry of its aquifer. The 87Sr/86Sr of bottled water, taken as a proxy for groundwater, showed regional variations consistent with those of rocks and vegetables, demonstrating that an 87Sr/86Sr map of water and agricultural products has value for determining the production areas of these substances. However, the value and range of 87Sr/86Sr differed among these three materials, and the degree of the difference between groundwater and rock depended on the rock type. An analysis of geochemical data from rocks and rainwater suggests that groundwater contains Sr and additional S derived from atmospheric sources such as rainwater and sea salt aerosols. The atmospheric contribution of Sr to groundwater is greatest in areas of siliceous sedimentary rocks with low Sr concentrations and high resistance to weathering. A weak correlation of δ34S of bottled waters with 87Sr/86Sr indicates the usefulness of maps of combined Sr and S isotope ratios for groundwater provenance. This study shows that for accurate provenance determinations of groundwater, organisms, and agricultural products, it is essential to better quantify the contributions of Sr and S from the atmosphere as well as from rocks and human activities.

Asunto(s)

Agua Potable/análisis , Monitoreo del Ambiente , Isótopos de Estroncio/análisis , Isótopos de Azufre/análisis , Contaminantes Químicos del Agua/análisis , Japón

RESUMEN

A sequential chemical separation technique for Cr, Fe, Ni, Zn, and Cu in terrestrial and extraterrestrial silicate rocks was developed for precise and accurate determination of elemental concentration by the isotope dilution method (ID). The technique uses a combination of cation-anion exchange chromatography and Eichrom nickel specific resin. The method was tested using a variety of matrixes including bulk meteorite (Allende), terrestrial peridotite (JP-1), and basalt (JB-1b). Concentrations of each element was determined by thermal ionization mass spectrometry (TIMS) using W filaments and a Si-B-Al type activator for Cr, Fe, Ni, and Zn and a Re filament and silicic acid-H3PO4 activator for Cu. The method can be used to precisely determine the concentrations of these elements in very small silicate samples, including meteorites, geochemical reference samples, and mineral standards for microprobe analysis. Furthermore, the Cr mass spectrometry procedure developed in this study can be extended to determine the isotopic ratios of 53Cr/52Cr and 54Cr/52Cr with precision of approximately 0.05epsilon and approximately 0.10epsilon (1epsilon = 0.01%), respectively, enabling cosmochemical applications such as high precision Mn-Cr chronology and investigation of nucleosynthetic isotopic anomalies in meteorites.

Asunto(s)

Medio Ambiente Extraterrestre/química , Temperatura , Elementos de Transición/análisis , Elementos de Transición/aislamiento & purificación , Cromo/análisis , Cromo/aislamiento & purificación , Cobre/análisis , Cobre/aislamiento & purificación , Hierro/análisis , Hierro/aislamiento & purificación , Isótopos , Espectrometría de Masas , Níquel/análisis , Níquel/aislamiento & purificación , Silicatos/química , Zinc/análisis , Zinc/aislamiento & purificación

RESUMEN

BACKGROUND: The typical response to burn stress causes burn shock, followed by a diuretic phase; however, fluid management remains crucial in this phase in the treatment of the elderly, patients with preexisting cardiac or renal diseases, and patients developing acute renal failure. We studied the effects of human atrial natriuretic peptide (hANP), which is a renal vasodilator, natriuretic, and inhibitor of renin secretion, on renal function in these patients with burn injuries. METHODS: Thirty-three severely burned patients (44.8% +/- 20.6% total burn surface area) with prolonged cardiovascular overload and pulmonary edema after burn shock receiving a continuous infusion of hANP (0.025 microg/kg/min and 0.05 microg/kg/min, hANP group) were compared with control (no-hANP group, n = 25). Vital signs, urine output (UO) and blood gas analysis before and 72 hour after the start of hANP were recorded. Creatinine clearance, free water clearance, and fractional excretion of sodium were also calculated. RESULTS: Sixteen (48%) patients were elderly, over 80 years old. Twenty (60%) had preexisting cardiovascular disease, renal insufficiency, or diabetes. hANP infusion increased UO in 25 (66%) cases and improved oxygenation in 31 (82%) cases. Treatment with hANP increased creatinine clearance, fractional excretion of sodium, and UO, except in four cases that had already progressed to complete renal failure before the infusion of hANP. CONCLUSIONS: Intravenous hANP seems to be effective for postresuscitative pulmonary dysfunction and renal function after burn shock in the vulnerable elderly, or patients with preexisting disease, suggesting that it could be valuable in facilitating fluid management in the acute phase in severely burned patients.

Asunto(s)

Factor Natriurético Atrial/uso terapéutico , Quemaduras/tratamiento farmacológico , Riñón/efectos de los fármacos , Pulmón/efectos de los fármacos , Choque Traumático/tratamiento farmacológico , Factores de Edad , Anciano , Anciano de 80 o más Años , Análisis de los Gases de la Sangre , Unidades de Quemados , Quemaduras/complicaciones , Quemaduras/mortalidad , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Femenino , Estudios de Seguimiento , Humanos , Infusiones Intravenosas , Puntaje de Gravedad del Traumatismo , Pruebas de Función Renal , Masculino , Persona de Mediana Edad , Probabilidad , Pruebas de Función Respiratoria , Mecánica Respiratoria/efectos de los fármacos , Medición de Riesgo , Choque Traumático/etiología , Choque Traumático/mortalidad , Estadísticas no Paramétricas , Análisis de Supervivencia

RESUMEN

BACKGROUND: Secondary abdominal compartment syndrome (ACS) is a lethal complication after resuscitation from burn shock, even after abdominal decompression (AD) is performed. This study investigated increased susceptibility to multiple organ dysfunction syndrome (MODS) in extensively burned patients with ACS. METHODS: Patients admitted to our burn unit between 2002 and 2005 with burns affecting 40% or more of the total body surface area without severe inhalation injury were analyzed. Hemodynamic parameters, blood gas analysis, and intrabladder pressure as intra-abdominal pressure were recorded. Serum interleukin (IL)-8 and IL-6 concentrations were measured in 20 of these patients. Lung injury score and Sequential Organ Failure Assessment scores were serially determined. RESULTS: Fourteen of 38 patients developed intra-abdominal hypertension in 22.9 +/- 8.9 hours postburn. Hemodynamic parameters in these 14 patients, including peak intra-abdominal pressure (46.6 +/- 11.2 to 19.8 +/- 9.9 cm H2O), peak inspiratory pressure (51.4 +/- 10.5 to 31.8 +/- 7.0 cm H2O), and abdominal perfusion pressure (51.3 +/- 18.3 to 73.9 +/- 13.6 mm Hg), were improved immediately after AD. Despite AD, lung injury score and Sequential Organ Failure Assessment scores increased significantly 2 and 3 days postburn in patients who required AD. Plasma concentration of IL-8 was elevated in intra-abdominal hypertension patients 3 days postburn. CONCLUSION: Intra-abdominal hypertension induced acute lung injury and MODS with IL-8 elevation, even though AD improved hemodynamic parameters in extensively burned patients.

Asunto(s)

Quemaduras/complicaciones , Síndromes Compartimentales/etiología , Insuficiencia Multiorgánica/etiología , Síndrome de Dificultad Respiratoria/etiología , Cavidad Abdominal , Síndromes Compartimentales/sangre , Síndromes Compartimentales/cirugía , Descompresión Quirúrgica , Humanos , Interleucina-8/sangre , Insuficiencia Multiorgánica/sangre , Síndrome de Dificultad Respiratoria/sangre

RESUMEN

We report a rare case of pseudo-Meigs' syndrome due to metastasis of breast cancer to both ovaries. A 34-year-old woman with exertional dyspnea was admitted to our hospital. Before entry the patient had undergone radical mastectomy for left breast cancer in June 1998. Resection and reconstruction of the chest wall for recurrence of the breast cancer had been performed in April 2001. Right pleural effusion was found on admission to our hospital in October 2002. Continuous thoracic drainage obtained 500-2000 ml of fluid per day. Cytologic results were both normal and benign, and cultures for bacteria and acid-fast bacilli were negative. During treatment of the pleural effusion, which proved to be cryptogenic and intractable, a huge pelvic tumor was found. The primary site was unknown. Surgery was performed in November 2002, and tumors were removed from both ovaries. The right pleural effusion vanished after surgery. Pseudo-Meigs' syndrome with metastasis of breast cancer to both ovaries was diagnosed. The patient died of cachexia related to the carcinoma in January 2005.

Asunto(s)

Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/patología , Síndrome de Meigs/etiología , Neoplasias Ováricas/secundario , Adulto , Neoplasias de la Mama/cirugía , Carcinoma Ductal de Mama/cirugía , Disnea/etiología , Resultado Fatal , Femenino , Humanos , Mastectomía , Síndrome de Meigs/terapia , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/cirugía

RESUMEN

BACKGROUND: Secondary abdominal compartment syndrome is a lethal complication after resuscitation from burn shock. Hypertonic lactated saline (HLS) infusion reduces early fluid requirements in burn shock, but the effects of HLS on intraabdominal pressure have not been clarified. METHODS: Patients admitted to our burn unit between 2002 and 2004 with burns > or =40% of the total body surface area without severe inhalation injury were entered into a fluid resuscitation protocol using HLS (n = 14) or lactated Ringer's solution (n = 22). Urine output was monitored hourly with a goal of 0.5 to 1.0 mL/kg per hour. Hemodynamic parameters, blood gas analysis, intrabladder pressure as an indicator of intraabdominal pressure (IAP), and the peak inspiratory pressure were recorded. Pulmonary compliance and the abdominal perfusion pressure were also calculated. RESULTS: In the HLS group, the amount of intravenous fluid volume needed to maintain adequate urine output was less at 3.1 +/- 0.9 versus 5.2 +/- 1.2 mL/24 h per kg per percentage of total body surface area, and the peak IAP and peak inspiratory pressure at 24 hours after injury were significantly lower than those in the lactated Ringer's group. Two of 14 patients (14%) in the HLS group and 11 of 22 patients (50%) developed IAH within 20.8 +/- 7.2 hours after injury. CONCLUSION: In patients with severe burn injury, a large intravenous fluid volume decreases abdominal perfusion during the resuscitative period because of increased IAP. Our data suggest that HLS resuscitation could reduce the risk of secondary abdominal compartment syndrome with lower fluid load in burn shock patients.

Asunto(s)

Abdomen , Quemaduras/complicaciones , Síndromes Compartimentales/prevención & control , Ácido Láctico/uso terapéutico , Solución Salina Hipertónica/uso terapéutico , Choque Traumático/terapia , Adolescente , Adulto , Anciano , Síndromes Compartimentales/etiología , Combinación de Medicamentos , Femenino , Humanos , Soluciones Isotónicas/uso terapéutico , Ácido Láctico/administración & dosificación , Masculino , Persona de Mediana Edad , Lactato de Ringer , Solución Salina Hipertónica/administración & dosificación , Choque Traumático/etiología

RESUMEN

Abdominal compartment syndrome (ACS) is rarely reported as a complication of severe burn. This study clarified the risk of burned patients with and without ACS, especially regarding the resuscitation fluid volume. Extensively burned patients admitted to our burn unit from January 2003, through to June 2004, were examined. Vital signs, blood gas analysis, bladder pressure to estimate intra-abdominal pressure (IAP), peak inspiratory pressure (PIP), resuscitation fluid volume, and urine output (UO) were analyzed. Intra-abdominal hypertension (IAH) was defined as an IAP of more than 30 cm of H2O. Eight of 48 patients suffering from a more than 30% total burn surface area developed ACS in 18.3+/-4.9 h. In these patients, IAP (49+/-12 cmH2O), PIP (50+/-16 cmH2O), heart rate (115+/-8/min), and PaCO2 (54.6+/-10.1 mmHg) were higher than normal, and their resuscitation volume was 0.40+/-0.11 L/kg. Also, a significant correlation between the IBP, PIP and resuscitation volume was observed. Most patients with severe burns required more than 300 mL/kg of resuscitation fluid for the first 24 h after injury that led to ACS and had higher HR, IBP, PIP and PaCO2 despite arterial pressure showing no significant difference.

Asunto(s)

Abdomen , Quemaduras/complicaciones , Síndromes Compartimentales/etiología , Fluidoterapia/métodos , Resucitación/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Superficie Corporal , Síndromes Compartimentales/tratamiento farmacológico , Femenino , Humanos , Masculino , Persona de Mediana Edad

RESUMEN

BACKGROUND: Abdominal compartment syndrome (ACS) can become fatal; however, it has rarely been described as a complication of burn injury. This study clarified the physiologic results of abdominal decompression (AD) for ACS in patients with burn injury in detail. METHODS: Extensively burned patients admitted to our burn unit between January 2003 and February 2004 were prospectively monitored by pulmonary artery catheter. Physiologic parameters from the catheter, blood gas analysis, intrabladder pressure as a parameter of intra-abdominal pressure (IAP), peak inspiratory pressure, and urine output (UO) were compared before and after escharotomy as AD in patients with ACS. RESULTS: Eight of 36 patients who had sustained more than 30% total body surface area burn developed ACS requiring AD in 18.3 +/- 4.9 hours. AD significantly decreased IAP (52 +/- 9 cm H2O vs. 26 +/- 7 cm H2O), peak inspiratory pressure (53 +/- 13 cm H2O vs. 35 +/- 6 cm H2O), heart rate, and Paco2, and increased cardiac index (1.6 +/- 0.7 L/min/m2 vs. 2.5 +/- 0.9 L/min/m2), abdominal perfusion pressure (50 +/- 11 mm Hg vs. 72 +/- 17 mm Hg), UO (0.45 +/- 0.46 mL/h/kg vs. 2.0 +/- 2.1 mL/h/kg), and oxygen delivery index (290 +/- 195 mL/m2/min vs. 455 +/- 218 mL/m2/min). Impaired oxygen consumption index increased (86 +/- 43 mL/m2/min vs. 153 +/- 58 mL/m2/min) after AD. CONCLUSION: In patients with severe burn injury, elevated IAP makes pulmonary artery wedge pressure and UO unreliable indices of preload or intravascular volume, and decreases abdominal perfusion in the resuscitation period. AD in these patients significantly improves the ventilation, hemodynamic parameters, and oxygen metabolism.

Asunto(s)

Abdomen/fisiopatología , Quemaduras/fisiopatología , Síndromes Compartimentales/fisiopatología , Síndromes Compartimentales/cirugía , Descompresión Quirúrgica , Vísceras/irrigación sanguínea , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Quemaduras/complicaciones , Síndromes Compartimentales/etiología , Femenino , Humanos , Persona de Mediana Edad , Consumo de Oxígeno , Presión , Estudios Prospectivos , Radiografía Abdominal

RESUMEN

We devised a procedure for the placement of a double-pigtail endoscopic retrograde biliary drainage (ERBD) tube as an alternative to the placement of a T-tube. We used the procedure, after primary closure of the common bile duct, in three patients undergoing surgery for choledocholithiasis. All three patients were in their eighties, and all were diagnosed with cholecystolithiasis and choledocholithiasis. In all three, there were concerns about possible complications with the use of a T-tube. Two of the patients were senile and were thought to be likely to pull out the tube, and incomplete fistulation was considered possible in the third patient. Thus, there was an increased risk of bile peritonitis in all three patients. Placement of the ERBD tube was successful in all three patients, and there were no postoperative complications. The hospital stay was a few weeks shorter than the usual stay with the placement of a T-tube. We conclude that primary closure of the common bile duct with the placement of a double-pigtail ERBD tube is clinically safe and advantageous for choledocholithiasis patients with senile dementia and for patients with possible incomplete fistulation.

Asunto(s)

Coledocolitiasis/cirugía , Conducto Colédoco/cirugía , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Drenaje/métodos , Anciano de 80 o más Años , Endoscopía , Femenino , Humanos

Asunto(s)

Educación de Pregrado en Medicina/métodos , Movimientos Oculares/fisiología , Fisiología/educación , Estudiantes de Medicina , Materiales de Enseñanza , Electrooculografía , Humanos

RESUMEN

Variations in the isotopic composition of some components in primitive meteorites demonstrate that the pre-solar material was not completely homogenized, nor was it processed at sufficiently high temperatures to erase the signatures of the diverse stellar sources. This is in accord with the observation that accretion disks of young stellar objects are at relatively low temperatures. Carbonaceous chondrites are considered to represent the 'average' Solar System composition; the rare pre-solar grains in the matrixes of carbonaceous chondrites have been used to identify some sources of the pre-solar material. Here we report that the molybdenum isotopic composition of bulk carbonaceous chondrites is distinctly different from the accepted average solar value. We show that the Mo data require the presence of material produced in at least two different r-processes, and that the contribution from the p-process material is decoupled from the r-process, all occurring in supernova explosions. This is consistent with the emerging picture of diverse sources inferred from short-lived isotopes in the early Solar System and elemental analyses of metal-poor stars.